bubble_chart Concept

Obesity refers to a body shape that is overweight, exceeding that of ordinary people. It is often accompanied by symptoms such as dizziness, lack of strength, reluctance to speak or move, and shortness of breath.

Neijing mentions "the noble fat person," and Jingui Yaolue records "excessive flesh." As for the "yellowish puffiness" mentioned in volume sixteen of Zabing Yuanliu Xizhu, it refers to a condition caused by "worms and food accumulation." This condition, characterized by yellowish puffiness and swelling of the face, is distinctly different from obesity.

If a person has a plump figure, a rosy complexion, full of energy, normal tongue and pulse, and no signs of illness upon examination, they do not fall into the category of obesity.

bubble_chart Pattern Analysis

1. Damp Phlegm︰The body is large and obese, with a strong appetite, especially for sweet and greasy foods. There is chest stuffiness and epigastric fullness, usually with copious phlegm, heavy and fatigued limbs, aversion to heat, a swollen tongue with thick and greasy coating, and a wiry, slippery, and forceful pulse. This is often caused by dietary irregularities, prolonged excessive appetite, or a preference for rich, sweet, and greasy foods, leading to impaired spleen function, which promotes dampness and phlegm formation. Phlegm-dampness accumulates in the body, resulting in obesity; it may also be related to congenital factors. This belongs to an excess pattern, characterized mainly by chest stuffiness, epigastric fullness, heavy and fatigued limbs, copious phlegm, a swollen tongue with greasy coating. Treatment should focus on dispelling phlegm and resolving dampness. The recommended formulas are Gallbladder-Warming Decoction or Stomach-Calming Powder, with additions such as hawthorn fruit, tea tree root, radish seed, and Six-to-One Powder as appropriate. It is also important to limit the intake of rich, sweet, and greasy foods.
2. Qi Deficiency︰The body is large and obese, with {|###|}shortage of qi{|###|}, laziness in speaking, spontaneous sweating upon exertion, aversion to cold, puffy and swollen face, slightly poor appetite, {|###|}mental fatigue{|###|}, and a tendency to sleep. The tongue is pale with a white coating, and the pulse is thin and weak. This condition is often caused by {|###|}overstrain{|###|} damaging qi or improper diet, leading to impaired {|###|}spleen qi{|###|}. As stated in Zabing Yuanliu Xizhu: "When grain qi overpowers {|###|}original qi{|###|}, the person becomes obese but does not live long." The appearance of {|###|}obesity{|###|} is merely superficial, while the {|###|}original qi{|###|} is actually deficient. The main symptoms include {|###|}shortness of breath and lack of strength{|###|}, as well as {|###|}aversion to wind and spontaneous sweating{|###|}. Treatment should focus on {|###|}tonifying qi and invigorating the spleen{|###|}. The recommended prescription is Cyperus, Amomum and Six Gentlemen Decoction. Additionally, physical exercise should be increased to strengthen the {|###|}constitution{|###|}.

The condition of obesity was rarely documented in ancient medical texts. In recent years, with the improvement of living standards, its incidence has shown an increasing trend, leading to other diseases and gradually gaining attention. The causes of obesity are complex, related to constitution, age, dietary habits, work-rest balance, emotional state, and genetic factors. Although clinical differentiation includes distinctions between deficiency and excess, they often coexist. For instance, prolonged phlegm-dampness often accompanies qi deficiency, and qi deficiency often leads to impaired spleen function, resulting in phlegm-dampness. Treatment requires not only pattern identification but also dietary regulation, appropriate physical labor or exercise, and comprehensive therapy to achieve effectiveness.

bubble_chart Documentation

1. Jingui Yaolue．Blood Impediment Deficiency Fatigue Pulse Signs and Treatment: "The noble and prosperous people have weak bones and abundant skin..."
2. 《Chinese Medicine Clinical Essentials》: "When a corpulent person gradually becomes emaciated, accompanied by excessive phlegm and cough, and gurgling sounds in the intestines, it is mostly due to the pattern of water fluid retention."